In this article, we will discuss Diabetic Neuropathy. In Diabetic patients, with time, the blood supply in the legs decreases, and this causes damage to the nerves in the legs.
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This problem is called Diabetic Neuropathy in medical terminology. And because of Diabetic neuropathy patient develops multiple symptoms like pain, burning sensation, numbness in the legs. These symptoms start from the toes and progress upwards. Also, this disease slowly involves calves, ankles. And in some diabetic patients, the symptoms even start developing in the hands. Diabetic neuropathy develops due to multiple factors like smoking, high blood pressure, high Triglyceride levels. Triglyceride is a type of fat which is found in the human body. Other than these, heart disease, obesity.. they also increase the risk of diabetic neuropathy Now we will discuss how diabetic neuropathy is diagnosed?
In the majority of cases of diabetic neuropathy is advanced Diagnostic techniques like nerve biopsy, nerve conduction studies, or imaging studies like CT scan, MRI scan are not needed. And the doctor by medical history and physical examination of the patient can make the diagnosis of diabetic neuropathy. In medical history, the doctor will ask about symptoms of the patient, the duration, and the association of the symptoms with other factors. These are some questions which the doctor will ask the patient. And in physical examination, the doctor will examine the feet of the patient and assess some signs like movement, the sensation of touch, pain, temperature, vibration sense. These sensations, the patient will not feel. So by medical history and by physical examination, majority of the cases of diabetic neuropathy are diagnosed by the doctors.
Treatment of diabetic neuropathy
Now we will discuss the treatment of diabetic neuropathy. In the treatment of diabetic neuropathy, the most important thing is adequate blood sugar con, troll, i.e., the patient's blood sugar level should be near normal levels. And in some cases, it has been found that by only adequate blood sugar control, the pain and burning sensations are cured and get resolved. Besides this, the patients should do the self-examination of the foot, every day. Patients should examine for ulcers, injuries, blisters, and broken skin. They should examine the feet every day carefully. And besides this, the patient should visit the doctor for an examination of the feet.
How to manage pain in diabetic neuropathy
Next, we will discuss how to manage pain in diabetic neuropathy? In diabetic neuropathy, most of the medicines belong to the antidepressant class or the anti-seizures class of the drugs, which are the drugs used in the treatment of epilepsy. And by the antidepressant and anti-seizure "Tag", many patients stop their treatment or they decrease the dose of these drugs. And because of this, the patient doesn’t get adequate relief in pain. And also sometimes the doctors because of the side effects of these drugs like excessive sleepiness, dizziness, confusion don't increase the dosage of these drugs to adequate levels. And because of these factors sometimes the patient doesn’t get relief in pain. But if these drugs are used in adequate dosage for the management of pain, then the patient will surely get relief from pain in diabetic neuropathy.
Which medicines are used in the management of pain
Now we will talk about, which medicines are used in the management of pain. First, we will talk about the tricyclic antidepressant class of drugs. These are also a type of antidepressant drugs. And this drug is started at low dosage and is given at bed time then the dose is escalated gradually week by week. Besides, tricyclic anti-depressant drugs are not prescribed in patients of heart diseases. Also, this drug is not given with Duloxetine which is also an antidepressant. But, it can be given with Pregabalin and Gabapentin named drugs. The side effects of tricyclic antidepressants are dryness of mouth, constipation, confusion, excessive sleepiness, dizziness. These were the side effects. If Tri-cyclic antidepressants are given in the adequate dosage then it will it work wonders in the management of pain in diabetic neuropathy The next drug is Duloxetine. Duloxetine is also a type of antidepressant drug. And this drug is also started in low doses. It is given once or twice a day. The side effects of this drug are constipation, decrease in appetite, increased sleepiness, dizziness.
Anti-seizure class of drugs
Now we will talk about anti-seizure class of drused to the management of pain in diabetic neuropathy. So the first drug in this class is Gabapentin. Gabapentin is given 3 times a day and because of gabapentin, the patient can feel or increased sleepiness or dizziness As these are the side effects of this drug. The next drug in this class is Pregabalin. This drug is started at a low dosage at night time i.e. bed time. Then it can be given up to three times a day. The side effects of this drug are weight gain, swelling in feet, increased sleeplessness, and dizziness. These are the side effects of this drug. And, Pregabalin and gabapentin can be given with tricyclic antidepressant class of drugs. Besides these drugs, lidocaine named anesthetic drug can be used in pitch pain relief. The patch of lidocaine is applied where the patient is feeling the maximum pain. And the effect of this patch lasts for 12 hours.
So this was some knowledge about diabetic neuropathy. And in the section of treatment, I have not discussed much about the dosage. I have only discussed the names of the drugs and their side effects. But dosage I have not discussed because your primary doctor will assess your present condition and will be in the best position to prescribe you the right dosage. So with this, we finish today's discussion. Stay healthy and keep your blood sugar levels under control. Thank you, Take care